Medically unexplained symptoms in children and adolescents: Illness-related self-concept and parental symptom evaluations, 2020, Jungmann and Witthöft

[Andy]

Highlights
• Medically unexplained somatic symptoms (MUS) are common in children and adolescents.
• In children/adolescents, MUS are associated with an illness-related self-concept.
• How parents evaluate symptoms is associated with children's health anxiety.
• Findings are in line with predictive-processing approaches to symptom perception.

Abstract
Background and objectives
According to cognitive-behavioral models, illness-related symptom evaluations and self-concepts play a pivotal role in the development and maintenance of medically unexplained somatic symptoms (MUS). However, illness-related cognitions related to MUS have rarely been studied in children/adolescents and their parents.

Methods
Seventy-eight children and adolescents (M = 14.2 years; 59% female) performed two versions of the Implicit Association Test (IAT) to measure the implicit illness-related and the implicit anxiety-related self-concept. Illness-related evaluations of unspecific symptoms were assessed via the Health Norms Sorting Task (HNST), and MUS as well as characteristics of somatic symptom disorder (SSD) via questionnaires.

Results
MUS were significantly positively associated with the explicit (r = 0.30, p < .01) and implicit illness-related self-concept (r = 0.24, p = .04), but not with the anxiety-related self-concept (r = 0.15, p = .18). The implicit illness-related self-concept explained incremental variance in MUS (ΔR2 = 0.05, p = .04) beyond the explicit illness-related self-concept. Regarding health anxiety, parental illness-related symptom evaluations moderated the relationship between child-reported severity of MUS and health anxiety (B = 0.12, p < .01).

Limitations
Some measures have been adapted for childhood and adolescence, but validations on larger samples are still pending.

Conclusions
A disorder-specific self-concept of being ill, as well as parental symptom evaluations, seem to play an essential role in MUS and health anxiety in childhood and adolescence. Due to the importance of the top-down processes found here, the findings are in line with current predictive coding models of somatic symptom perception.

Paywall, https://www.sciencedirect.com/science/article/pii/S0005791619301946
Not available via Sci hub at time of posting

 

[Hoopoe]

The abstract is not very clear but there doesn't seem to be a control group that could tell us whether this patient population is more "consumed" by their illness than what would be normal in the circumstances.

I also find the BPS model highly stigmatizing. They are creating stigma where they need not be any, apparently just to advance their careers.

 

[Snow Leopard]

More researchers confusing cause with effect.

 

[Arnie Pye]

How parents evaluate symptoms is associated with children's health anxiety.

My parents approach to illness in their children involved finding two things - visible symptoms and a raised temperature. If these didn't both exist then the child was lying.

 

[Invisible Woman]

Yep, mine too @Arnie Pye. If you were screaming then you were breathing and would probably be fine.